Abstract 16969: Burden of Cardiovascular Disease, ECG Patterns and Echocardiographic Data Among COVID-19 Survivors and Non-Survivors at a Large Health System in New York

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Arvind Devanabanda ◽  
Eitezaz Mahmood ◽  
Avneet SINGH ◽  
Perwaiz Meraj ◽  
Haisam Ismail ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
Clinical Outcomes ◽  
Inflammatory Markers ◽  
Bundle Branch Block ◽  
Icu Stay ◽  
Prognostic Importance ◽  
Artery Disease ◽  
Metabolic Comorbidities

Introduction: The prognostic importance of cardiac and metabolic risk factors among COVID-19 patients is unknown. The aim of our investigation is to report clinical significance of risk factors, ECG patterns, inflammatory markers and LVEF for survival with COVID-19. Methods: 10,018 patients and ECGs, from 13 hospitals in New York City area were included in this retrospective analysis between March 1 and April 30, 2020. Survivors and non-survivors were studied for presence of comorbidities and clinical outcomes of length of stay (LOS), ICU stay, ventilator use, inotrope use and pressor use. Differences between the groups were compared with the Student t test. Results: There were 7,837 survivors and 2,181 non-survivors. Table shows more patients with age > 65 died. Hypertension, diabetes, obesity, coronary artery disease, heart failure and peripheral vascular disease, COPD, chronic kidney disease were significantly elevated in non-survivors. Admission Inflammatory markers were significantly elevated in non-survivors. Significantly increased ECG intervals of QRS, QTc, atrial fibrillation, atrial flutter, and bundle branch block were noted in non-survivors. LVEF < 40% was significantly higher in non-survivors. ICU stay, LOS, pressor use and ventilator use were significantly elevated in non-survivors. Conclusions: More patients with age > 65 were survivors. Among non-survivors, cardiac, metabolic comorbidities, burden of atrial arrhythmias, admission inflammatory markers, LVEF< 40%, and clinical outcomes were significantly worse.

scholarly journals Infarction of the Splenium of the Corpus Callosum in the Age of COVID-19

Stroke ◽  
2020 ◽  
Vol 51 (9) ◽  
Author(s):  
Steven A. Sparr ◽  
Phyllis L. Bieri
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Corpus Callosum ◽  
York City ◽  
Inflammatory Markers ◽  
Medical Center ◽  
Montefiore Medical

Background and Purpose: Ischemic infarction of the corpus callosum is rare and infarction isolated to the corpus callosum alone rarer still, accounting for much <1% of ischemic stroke in most stroke registries. About half of callosal infarctions affect the splenium. Methods: During a 2-week period, at the height of the coronavirus disease 2019 (COVID-19) pandemic in New York City, 4 patients at Montefiore Medical Center in the Bronx were found to have ischemic lesions of the splenium of the corpus callosum, 2 with infarction isolated to the corpus callosum. Results: All patients tested positive for COVID-19 and 3 had prolonged periods of intubation. All had cardiovascular risk factors. Clinically, all presented with encephalopathy and had evidence of coagulopathy and raised inflammatory markers. Conclusions: Infarction of the splenium of the corpus callosum is exceedingly rare and a cluster of such cases suggests COVID-19 as an inciting agent, with the mechanisms to be elucidated.

scholarly journals Sex-specificity of mortality risk factors among hospitalized COVID-19 patients in New York City: prospective cohort study

2020 ◽  
Author(s):  
Tomi Jun ◽  
Sharon Nirenberg ◽  
Patricia Kovatch ◽  
Kuan-lin Huang
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
New York ◽  
New York City ◽  
Cohort Study ◽  
Coronary Artery ◽  
Lactate Dehydrogenase ◽  
York City ◽  
Male Sex ◽  
Artery Disease

Objective: To identify sex-specific effects of risk factors for in-hospital mortality among COVID-19 patients admitted to a hospital system in New York City. Design: Prospective observational cohort study with in-hospital mortality as the primary outcome. Setting: Five acute care hospitals within a single academic medical system in New York City. Participants: 3,086 hospital inpatients with COVID-19 admitted on or before April 13, 2020 and followed through June 2, 2020. Follow-up till discharge or death was complete for 99.3% of the cohort. Results: The majority of the cohort was male (59.6%). Men were younger (median 64 vs. 70, p<0.001) and less likely to have comorbidities such as hypertension (32.5% vs. 39.9%, p<0.001), diabetes (22.6% vs. 26%, p=0.03), and obesity (6.9% vs. 9.8%, p=0.004) compared to women. Women had lower median values of laboratory markers associated with inflammation compared to men: white blood cells (5.95 vs. 6.8 K/uL, p<0.001), procalcitonin (0.14 vs 0.21 ng/mL, p<0.001), lactate dehydrogenase (375 vs. 428 U/L, p<0.001), C-reactive protein (87.7 vs. 123.2 mg/L, p<0.001). Unadjusted mortality was similar between men and women (28.8% vs. 28.5%, p=0.84), but more men required intensive care than women (25.2% vs. 19%, p<0.001). Male sex was an independent risk factor for mortality (OR 1.26, 95% 1.04-1.51) after adjustment for demographics, comorbidities, and baseline hypoxia. There were significant interactions between sex and coronary artery disease (p=0.038), obesity (p=0.01), baseline hypoxia (p<0.001), ferritin (p=0.002), lactate dehydrogenase (p=0.003), and procalcitonin (p=0.03). Except for procalcitonin, which had the opposite association, each of these factors was associated with disproportionately higher mortality among women. Conclusions: Male sex was an independent predictor of mortality, consistent with prior studies. Notably, there were significant sex-specific interactions which indicated a disproportionate increase in mortality among women with coronary artery disease, obesity, and hypoxia. These new findings highlight patient subgroups for further study and help explain the recognized sex differences in COVID-19 outcomes.

scholarly journals A risk index for COVID-19 severity is associated with COVID-19 mortality in New York City

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wil Lieberman-Cribbin ◽  
Naomi Alpert ◽  
Raja Flores ◽  
Emanuela Taioli
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
York City ◽  
Underserved Populations ◽  
Risk Index ◽  
Data Repository ◽  
Severe Illness ◽  
Mortality Data ◽  
Cross Sectional

Abstract Background New York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection. Little is known about how the presence of chronic risk factors correlates with mortality at the population level. Here we determine the relationship between these factors and COVD-19 mortality in NYC. Methods A cross-sectional study of mortality data obtained from the NYC Coronavirus data repository (03/02/2020–07/06/2020) and the prevalence of neighborhood-level risk factors for COVID-19 severity was performed. A risk index was created based on the CDC criteria for risk of severe illness and complications from COVID-19, and stepwise linear regression was implemented to predict the COVID-19 mortality rate across NYC zip code tabulation areas (ZCTAs) utilizing the risk index, median age, socioeconomic status index, and the racial and Hispanic composition at the ZCTA-level as predictors. Results The COVID-19 death rate per 100,000 persons significantly decreased with the increasing proportion of white residents (βadj = − 0.91, SE = 0.31, p = 0.0037), while the increasing proportion of Hispanic residents (βadj = 0.90, SE = 0.38, p = 0.0200), median age (βadj = 3.45, SE = 1.74, p = 0.0489), and COVID-19 severity risk index (βadj = 5.84, SE = 0.82, p <  0.001) were statistically significantly positively associated with death rates. Conclusions Disparities in COVID-19 mortality exist across NYC and these vulnerable areas require increased attention, including repeated and widespread testing, to minimize the threat of serious illness and mortality.

Clinical and Demographic Risk Factors for COVID-19 during Delivery Hospitalizations in New York City

2021 ◽  
Author(s):  
Desmond Sutton ◽  
Timothy Wen ◽  
Anna P. Staniczenko ◽  
Yongmei Huang ◽  
Maria Andrikopoulou ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
Logistic Regression ◽  
York City ◽  
Demographic Data ◽  
Outcome Data ◽  
Demographic Risk ◽  
Demographic Risk Factors ◽  
Zip Code

Objective This study was aimed to review 4 weeks of universal novel coronavirus disease 2019 (COVID-19) screening among delivery hospitalizations, at two hospitals in March and April 2020 in New York City, to compare outcomes between patients based on COVID-19 status and to determine whether demographic risk factors and symptoms predicted screening positive for COVID-19. Study Design This retrospective cohort study evaluated all patients admitted for delivery from March 22 to April 18, 2020, at two New York City hospitals. Obstetrical and neonatal outcomes were collected. The relationship between COVID-19 and demographic, clinical, and maternal and neonatal outcome data was evaluated. Demographic data included the number of COVID-19 cases ascertained by ZIP code of residence. Adjusted logistic regression models were performed to determine predictability of demographic risk factors for COVID-19. Results Of 454 women delivered, 79 (17%) had COVID-19. Of those, 27.9% (n = 22) had symptoms such as cough (13.9%), fever (10.1%), chest pain (5.1%), and myalgia (5.1%). While women with COVID-19 were more likely to live in the ZIP codes quartile with the most cases (47 vs. 41%) and less likely to live in the ZIP code quartile with the fewest cases (6 vs. 14%), these comparisons were not statistically significant (p = 0.18). Women with COVID-19 were less likely to have a vaginal delivery (55.2 vs. 51.9%, p = 0.04) and had a significantly longer postpartum length of stay with cesarean (2.00 vs. 2.67days, p < 0.01). COVID-19 was associated with higher risk for diagnoses of chorioamnionitis and pneumonia and fevers without a focal diagnosis. In adjusted analyses, including demographic factors, logistic regression demonstrated a c-statistic of 0.71 (95% confidence interval [CI]: 0.69, 0.80). Conclusion COVID-19 symptoms were present in a minority of COVID-19-positive women admitted for delivery. Significant differences in obstetrical outcomes were found. While demographic risk factors demonstrated acceptable discrimination, risk prediction does not capture a significant portion of COVID-19-positive patients. Key Points

scholarly journals Estimation of HIV Prevalence, Risk Factors, and Testing Frequency among Sexually Active Men Who Have Sex with Men, Aged 18–64 Years—New York City, 2002

2007 ◽  
Vol 84 (2) ◽  
pp. 212-225 ◽  
Author(s):  
Susan E. Manning ◽  
Lorna E. Thorpe ◽  
Chitra Ramaswamy ◽  
Anjum Hajat ◽  
Melissa A. Marx ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
York City ◽  
Hiv Prevalence ◽  
Sexually Active ◽  
Testing Frequency ◽  
Sex With Men

Cardiovascular Disease Risk Factors Among Immigrant and US-Born Adults in New York City

2021 ◽  
pp. 003335492110075
Author(s):  
Claudia Chernov ◽  
Lisa Wang ◽  
Lorna E. Thorpe ◽  
Nadia Islam ◽  
Amy Freeman ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
New York ◽  
New York City ◽  
Health Insurance ◽  
York City ◽  
The United States ◽  
Nutrition Examination Survey ◽  
Health And Nutrition

Objectives Immigrant adults tend to have better health than native-born adults despite lower incomes, but the health advantage decreases with length of residence. To determine whether immigrant adults have a health advantage over US-born adults in New York City, we compared cardiovascular disease (CVD) risk factors among both groups. Methods Using data from the New York City Health and Nutrition Examination Survey 2013-2014, we assessed health insurance coverage, health behaviors, and health conditions, comparing adults ages ≥20 born in the 50 states or the District of Columbia (US-born) with adults born in a US territory or outside the United States (immigrants, following the National Health and Nutrition Examination Survey) and comparing US-born adults with (1) adults who immigrated recently (≤10 years) and (2) adults who immigrated earlier (>10 years). Results For immigrant adults, the mean time since arrival in the United States was 21.8 years. Immigrant adults were significantly more likely than US-born adults to lack health insurance (22% vs 12%), report fair or poor health (26% vs 17%), have hypertension (30% vs 23%), and have diabetes (20% vs 11%) but significantly less likely to smoke (18% vs 27%) (all P < .05). Comparable proportions of immigrant adults and US-born adults were overweight or obese (67% vs 63%) and reported CVD (both 7%). Immigrant adults who arrived recently were less likely than immigrant adults who arrived earlier to have diabetes or high cholesterol but did not differ overall from US-born adults. Conclusions Our findings may help guide prevention programs and policy efforts to ensure that immigrant adults remain healthy.

Risk Factors for New Neurological Diagnoses in Hospitalized COVID-19 Patients: A Case-Control Study in New York City

2021 ◽  
Author(s):  
Kiran Thakur ◽  
Victoria T. Chu ◽  
Christine Hughes ◽  
Carla Y. Kim ◽  
Shannon Fleck-Dardarian ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
York City ◽  
Case Control Study ◽  
Case Control ◽  
Control Study

scholarly journals Clotting of Hemodialysis Access in Patients with COVID-19 in an Inner-City Hospital

Nephron ◽  
2021 ◽  
pp. 1-6
Author(s):  
Jie Ouyang ◽  
Siddhartha Bajracharya ◽  
Sabu John ◽  
John Wagner ◽  
Jiehui Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
Clinical Manifestations ◽  
Kidney Injury ◽  
Dialysis Access ◽  
City Hospital ◽  
Kings County ◽  
Thrombotic Complications ◽  
High Bmi

<b><i>Background:</i></b> An increased incidence of thrombotic complications in patients with coronavirus disease 2019 (COVID-19) has been reported. Severe acute kidney injury (AKI) is one of the major clinical manifestations of COVID-19 with the need for renal replacement therapy. It was observed that hemodialysis (HD) accesses tended to thrombose more often in the COVID-19 population than in non-COVID-19 patients. We hypothesize that the hypercoagulable state of COVID-19 is associated with higher incidence of access clotting. <b><i>Method:</i></b> In this retrospective single-centered study at Kings County Hospital in New York City, 1,075 patients with COVID-19 were screened, and 174 patients who received HD from January 3, 2021 to May 15, 2020 were enrolled to examine the risk factors of dialysis access clotting in patients with COVID-19. <b><i>Results:</i></b> Of the 174 patients, 109 (63%) were COVID-19 positive. 39 (22.6%) patients had dialysis access clotting at least once during their hospitalization, and they had significantly higher body mass index (BMI) (<i>p</i> = 0.001), higher rates of COVID-19 (<i>p</i> = 0.015), AKI (<i>p</i> &#x3c; 0.001), higher platelet counts (<i>p</i> = 0.029), higher lactate dehydrogenase levels (<i>p</i> = 0.009), and lower albumin levels (<i>p</i> = 0.001) than those without access malfunctions. Low albumin levels (<i>p</i> = 0.008), AKI (<i>p</i> = 0.008), and high BMI (<i>p</i> = 0.018) were risk factors associated with HD access clotting among COVID-19 patients. <b><i>Conclusion:</i></b> Patients with COVID-19 who receive HD for AKI with high BMI are at a higher risk of clotting their HD access.

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